Provider Demographics
NPI:1700277795
Name:INTERNATIONAL MEDIA ARTS CORPORATION
Entity Type:Organization
Organization Name:INTERNATIONAL MEDIA ARTS CORPORATION
Other - Org Name:IMAC MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MUSABBIR
Authorized Official - Middle Name:HOSSAIN
Authorized Official - Last Name:CHOWDHURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-259-6302
Mailing Address - Street 1:24237 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2907
Mailing Address - Country:US
Mailing Address - Phone:661-259-6302
Mailing Address - Fax:661-259-6309
Practice Address - Street 1:24237 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2907
Practice Address - Country:US
Practice Address - Phone:661-259-6302
Practice Address - Fax:661-259-6309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity HealthGroup - Multi-Specialty